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HomeMy WebLinkAbout008-2009-02-000 (2)Wisconsin Department of Commerce Sefety and Building Division PRIVATE SEWAGE SYSTEM INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes (Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Cawle ,Sean Eau Galle, Town of CST BM Elev: Insp. BM Elev: BM Description: /~a • ~ /0 6 ~ ~ C;~,a~ TANK INFORMATION ~ ELEVATION DATA TYPE MANUFACTURER CAPACITY Septic f ,,., Dosing ~ ~ J~ ~ / D w.. S~ O F` ~a ~ a Iz v~ZS Holding TANK SETBACK INFORMATION TANK TO ~ P/L 0 WELL BLDG. Vent to Air Intake ROAD Septic ~ ~~ .~ Dosing A / l.~i ~~ Aeration Holding PUMP/SIPHON INFORMATION / ~ % I ~ Y~~ Manufacturer ~ ~U ~ Demand GPM Model Number ^ ~ ~ 7 •J , TDH Li~' ~ t Friction Loss System ead~ t TDH Ft Forcemain Length / Dia. i/ 3Sc Z Dist. to Well ~ N SOIL ABSORPTION SYSTEM county: St. Croix Sanitary Permit No: 514980 0 State Plan ID No: Parcel Tax No: 008-2009-08-000 Section/Town/Range/Map No: 01.28.16.575 STATION S B~ !~I FS ~~. Benchmark Alt. BM F;1 Go / ~ 7 ~ ~~ Bldg. Sewer q ,75 ~5, ~3 SUHt Inlet je ~ l ~ ys. y ~ SUHt Outlet ~ ~. Dt Inlet \. Dt Bottom 1 9i, y`,~ Header/Man. ~• ~ ~ ?+ Dist. Pipe Z • 3$ ~d 3, z_ Bot. System Paz. c•B Final Grade , ~ /D . ~ Z~ ; St Covey.; 4~ t^ J! ~ ~ ~dj~ ~ Z --i~~ 3. ~ ~. ~ BED/TRENCH Width ~ Length No. Of enc PIT DIMENSIONS No. Of its Inside Dia. Liquid Depth DIMENSIONS /_ ~~ ~ `"-- ~ ~ SETBACK INFORMATION SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING CHAMBER OR Manufacturer: Type f ystem: ~~ ~ UNIT Model Number: J /~ ~~ O DISTRIBUTION SYSTEM _~GCLIn..,...1 Header/Manifold y Distribution I ~ x Hole Size ~ ~ x Hole Spacing ~/ Ve o Air Intake l Length~_ Dia ~~ ~ pipe(s) Length Dia ~ Z ~ Spacing t Q v ~/ Oft SOIL COVER , x Pressure Systems Only xx Mound Or At-Grade Systems Only ~ ~ _ Gt^''~ "`"yam' Depth Over Bed/T'rench Center ~ ~ ~ Depth Over Bed/Trench Edges \ xx Depth of Topsoil xx Seeded/Sodded xx Mulched ~Y,~s ~ No Yes ~ No COMMENTS: (Include code discrepencies, persons present, etc.) Ins lion #1: ~ l 3a h~ Inspection #2: / / ~~~ ~~ ~ - Location: 2683 59th Ave~jod~, WI 54028 (NE 1/4 NE 1/4 1 T28N R16W) hite Pine Meadows Lot 8 P~a~rcel®,N.o,~~01.28.16.575 1.) Alt BM Description = ~ ~ ~~~ G~,q;,^,~ ~ .. C~~"r"r ~"-"«~ 2.) Bldg sewer length = O I - amount of cover = / {~-°~~ b ~~ ~ ~~.. ' Hb~ ~v0~ `>~ Plan revision Required? ^ Yes ~ N Use other side for additional information. SBD-6710 (R.3/97) 16-~~ ~ - ~ ~~~ Date Insepctor's ignature Cert. No. (/~ ` fj~ +carf'1me[~.YW.gOV Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 ~~r ~, ~, r, O n $ i ~ Madison, WI 53707-7162 ganitary permit Number {m be fitkA in 6y Co,) iopnrltntlint ott t:otndmslroe ~ S ~ l , '1 Sanitar Permit A lic ti SiateTransact ion Number y pp a on In accordance with s. Comm. 83.2!(2), Wis. Adm. Cade, submission of this form to the 8 unit is re uired ri b i i C / 5 O ,,3 S q p or to o ta n ng a sanitary permit. Note: Application forms for State WTS submitted to the Departmestt of Commerce, personal information you •~ Address (if different than mailing address) u es in accordance with the Priv Law s. l 5,0 l m Slats. ~ ~ / g ~ C i 1 I A lic tio I f k ' ~ ~~ l0 J d'T~- . a n n ormat -H -Please Print A fo n Properly Owner's Natne / ~ 3 partx, # pOg"- ZG~ - OS- tab ~ Property Owner's Mailing Address ~ r -- ST CROiX CO property Location /' ~ 15 ~ ~ ~ 7 . UNTY Y Govt Lot ( City, State Zip Code ~~~ ~/y /t/L~ '/., Secticm T R `~ ~ N 1 B # ^ ~ ~W ~ ' . Type of 1 and (check all that apply) a f~ ~ Lot ~I or 2 Famil Dw lli N b f B d ~ ton Name iti Subdiv y e ng - um er o e ' ~~ , _ p ~ PubliclC°mmercial -Describe Use ~< <„ ~.o.N,~ cityof ----_ ^ State Owned -Describe Use CSM Number ^ Vinage of ~ ~ ^n ~ Town of ~ Q. CG ~~~G ill. Type of Permit: (Check only one box on line A. Complete line B it applicabit) A• New System Replacement Treatntetn/Holding Tank Replacement Only Other' Modification to Exiaring System (explain) System B. Permit permit Revision Change of Permit TransFer ro Lint Previous Permit Number and Date Issued Renewal Before Plumber New Owner Ex iration IV. T of IPOWTS S tem/Com nent/Deviee: Check all tlwt Non-Pressurized In-(Iround Pttssuriud In-C3luund At-Clrade Mound ? ~ in. of suitable soil Mound < ?A in. of suia~le soil ^ Holding Tank ^ Other Dispersal Component (explain)Pretreatment Device (explain) v. Die rsaVl'rea ant Area Information: '` ~ Design Flow (gpd) Design Soil Application Rate( Dispersal Area)iequired Dispersal Area sf) System Elevation ~~ ° ~ J D2, S~ ~o pct I G~ GorJ (~~ VI, Taek Info Cap~ity in Total # of ~ufactitra M ~1 ~ ~ ~• ~ ~ (, _ t3allons Ciallona Units // ~ ~ `/~ /'d ~ ' / r'`~- New Tanks E.xnrting Tanks '-e4CY Septic err Holding Tank ,~~ QO ,/ ~ 4y ~ Y' ~ Dosing Chamber V ~ 0 ~ ` ~i ,.,SG y ~ ~ // Re onsibility Statement- I, the nodeeaf~aed, sesame trespottalbtlky for irtstaitatioa of tYe )~'OW 1'3 VIi ~ t1m a~e~ Pte' , Plumber's Name (Prinil Plumber's Signature Number Basirrrss Phone Number a?4~D ?1 -~_ -.~izr lJ-:iirQ,~ S~ u.~+a/!zY 6c/ Plumber's Address (Street, City, State, Zip Cade) 1'~ ~6 0~ G'../ l to YI Coen /D t se On Approved iseppro permit Foe Dare Isstrirrg Signatu _ Owner (}' for Denial $ / ~ ~j ~ g D'~ lQ IX. Cnndit$Ipg'(iENI{~k~!~NiB~teasons for Diisapprovaf 3~ L a,~,~; i-i o,s,5 i n ~J~' n ~e. ~I' P{oJ l'G ~`'`' r"'L 1. Septic tank, eiflUent filter and ~, ~ w ~ ~~ of ,,~1 ~ e f a ~l . ~ ma dispersal cell must all be senrices ~ as per management plan provided by plumber. 2, pp tsquirtarrtertts mast be maintained tmw / ww~ww~... AMeeh to cmrplete phars ~r the s9ateta and wlnrMt m she County au[9 on 1MPp' net Ips Ann S rIS x 11 tweAer rn atre $3 SBD-fi398 (li. 01107) Valid t4ttu 01/09 . ~ ~oCtLLt-cf Soi% C /a./u~c.~lor7 poi • Cxi's 6'~ 8 ride e%~ . Sbee/ T-/oorf sct ~f /ot eorr~v Scree / =~fd ~1F~'~~ES-y 5cc.~ r..zB~l. ~PxG~; T. g''~u u 6'a//< SE . CroirCo. ~J/ ,o v ~ oc~ -,uo9- oB ~ 6ei~ 3.67oc~cs ~~„~ ~ot~i L_ W,'eSe/Coxrcf2 cJ~P/~o/b~rz Poky La.rP.L • S2S[~'/u ~ ~; z °s~. s~oPV, 4 ~ce.rca::rJ- ~~~ b ~4rgbC `\ .// -. ., PrBpoud bulrcr».r~ ~fOposer! 1~r~~eu~ay z "sJ~. s/o P. ~ c, .~,su/sea./ /i93CC/4'f,Cd~~Of 6enf2Yfi g~ ~p~ `fl" G,.fou.r -- - ~• ~p0. c77' - - ____ __ -- --- ~ _qy~. ' - - ! -f ba..~c- Area /s~ - l f f 0~ ~ lS~"~„J'_~- fez - ~ _ (_ .- ~ I ~f ~ \ ~ (cPL ~c,Y~ ,r- -'3-y Stc pt3t5:d~ncR L PaxdW(~/ /oCcc~ on or,. .nab C~erna~l ~~' ~ou.,d brc~a~ adz ~z~•: ql• a[~oor~ tG~GP~iDnC ~o~. ~}C[A eu,~r. _ ~~. to' COr;~;.-~/ rg.~ ~ou.,d -la pia/e (oec.-~ ) \d,sEcvb<al. /~;ovr(S~t fv u1(GS ct/tvna:h~,;,/ F e: ©r,8in~ d./+'/.1 d,ISfcc,~6ed o..d/o~ desErcyes~'. .SYSfa..-t /OGaleio~ ~s/eca..~'ar, a~-ei~.er.-~,%~ed by ~-cyd i dance ~~C~c'~'o.~ c{ sa % Q da/u4 ~ o.-~ ~: E /o ca:u`vr~S o.,c,~ eIr/n-i:'o.~S. ~1Q~ pc~mQ..~mt. [3 ~+1. ~ ~C~n.~na-fie E~ rv/, e5~~i~5`i~. C~COPV ~~=~y ~9 . Sbee/ T-Potf SLt ~t /of eornv Sc~,/c : ; = ~d yen ~ (~ ~/<y,o~goa.I'E~', Tn. 'Eau Ga//~ S~. ~,-oit-C.; ~J/. bf,:~ 3, (o7ocrF.s no~'fli /o~~/ W,~ISe/ Co~c.rcEe c.~~/o/,ZGD~', Cony bi na.~'or1 S.r/p t'. w; t~ ~i i ~~~• o ~ar~e ., PrePoscd bcdrenm / ~ /9' p~ppose~d .L~, r;0eu~4Y ,Z "Sc/a • f/!J Pv C ~ ~i.s4./.Sf4/ ,p ~ Cr..z~o>...r /rJ3tc/atfCd ~Oi~Of b[n. ft7`~i 8! _ /O/• - - -- _ .. ba,~ ArQa_ u$,3 _ ~~ ~ /o'~~ I ,y~•44 _ 5yS ,~~ S: d~~L~ ProP°x°' ~~ ~ /O(~4~s'OI7 or,' •.w~.~ L~rncc~C ql• a6ac~~ Barr, wlw~K ~ 7ep of -~(ep~o~e ~o.c.~J. f~s~~ Ib.~ :Top o{!Xv'.sc,~l.~/c~ R/, e. d,sEwfcd. ~;orres~ fao uSf4.5 ali`v>'laX'~; h e: ©~>~in~••~ CMS d;Sf.c.ee(~e-d o-.d~o~ desfisy~. sysf~~, /oc.~fa,~ ~'e/etJa,~~o>, d~--•-~,:,cd by f;-~/~ idan~~C~c-~;o.~ o{Sa%Q/a/u4fro.-~~%E /oc~%'onS o.~,% ~(e/c~'onS. ~lQ„~~o.~~Ma.,~---rf. a.Kl. 4 GC~n.~r~~e L{~. es ~6/;,s ~ ~.d. ~9.~~''y commerce,wi,gov ^ ~scons~n Department of Commerce Safety and Buildings 3824 N CREEKSIDE LA HOLMEN WI 54636 TDD #: (608) 264-8777 www. commerce. wi.gov/sb/ www.wisconsin,gov Jim Doyle, Governor Jack L. Fischer, A.I.A., Secretary August 25, 2008 CUST ID No. 227990 WILLIAM C SCHUMAKER SCHUMAKER PLUMBING 1070 SCOTT RD HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 08/25/2010 SITE: Sean Cawley 2683 59TH Ave Town of Eau Galle St Croix County NE1/4, NE1/4, S1, T28N, R16W Lot: 8, Subdivision: White Pine Meadows ATTN: POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 Identification Numbers Transaction ID No. 1583513 Site ID No. 741683 Please refer to both identification numbers, above, in all corres ondence withthe a enc . FOR: Description: Mound /Four Bedroom /Sloping Site Object Type: POWTS Component Manual Regulated Object ID No.: 1197557 Maintenance required; 600 GPD Flow rate; 14 in Soil minimum depth to limiting factor from original grade; System: Mound Component Manual -Version 2.0, SBD-10691-P (N.O1/O1), Pressure Distribution Component Manual -Version 2.0, SBD-10706-P (N.O1/O1); Biofilter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: Reminders • This system is to be constructed and located in accordance with the enclosed approved plans and with the component manuals listed above. • Per manual cited above, limited activities are allowed in the area 15 feet down slope of the component arm. Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal are prohibited. LONG • The well must be a minimum of 25' feet from any POWTS tank, and a minimum of 50 feet from the absorption ~~~~ area. chs. NR 811 & 812c • A Sanitary Permit must be obtained from the county where this project is located in accordance with the ~ requirements of Sec. 145.135 and 145.19, Wis. Stats. ~ SEE C~3Ri • Inspection of the POWTS installation is required. Arrangements for inspection shall bemade with the designated county official in accordance with the provisions ofSec. 145.20(2)(d), Wis. Stat . WILLIAM C SQIUMAKER Page 2 8/25/2008 • Comm 83.22(7) A cogy of the approved Mans, specifications and this letter shall be orrsite during? construction and open to inspection by authorized representatives of the Department, which may include local inspectors. Owner Responsibilities: • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.55 The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. All permits required by the state or the local municipality shall be obtained prior to commencement of construction installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions ~-ould conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. . The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, ~~~ ~ ~~ Charles L Bratz POWTS Reviewer II ,Integrated Services (608)789-7893 , 7:45 am - 4:30 pm Monday -Friday charles.bratz@wisconsin.gov Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 WiSMART code: 7633 cc: Leroy G Jansky, POWTS Wastewater Specialist, (715) 726-2544 ,Friday, -7:00 A.M. To 3:30 P.M. James K Thompson , A.C.E. Soil and Site Evaluations gFCF~~ MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIG~I~'jG ~d P,4sidential Application SgF~C~ 21 X008 INDEX AND TITLE PAGE ~eU~~~/ NHS Project Name: Sean Cawley 4-bedroom residential mound Owner's Name: Sean Cawley Owner's Address: 10150 City Walk Dr. Woodbury, MN 55129 Site Address: 2683 59th Street Legal Description: NE1/4 NE/4, Sec.1, T.28N., R.16W. Township: Eau Galle County: St. Croix Subdivision Name: White Pine Meadows Lot Number: 8 Block Number: Na Parcel I.D. Number: 008-2009-08-000 Plan Transaction No.: Page 1 Page 2 Page 3 Page 4 Page 5 Page 6 Page 7 Page 8 Page 9 Index and title Data entry Mound drawings Lateral and dose tank System maintenance specifications Management and contingency plan Pump curve and specifications Site Plan Attached soil evaluation report Designer: Bill Schumaker License Number: Date: 08/12/08 Phone Number: Signature: /.lJ.~..~=-~~.~~-.r-- 227990 (715)386-3121 Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB-10691-P (N. 01/01), and both SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01) Version 5.1 (R. 06/06) Page 1 of 9 %'tionrrdly ~a~ED -`TE ERCE ~~NGS G DESPONDENCE Mound and Pressure Distribution Component Design Site Inform ation R Residential or Commercial Design 400.00 Estimated Wastewater Flow (gpd) 1.50 Peaking Factor (e.g. 1.5 = 150%) 600.00 Design Flow (gpd) 5.00 Site Slope (%) 100.75 Contour Line Elevation (ft) 14.00 Depth to Limiting Factor (in) 0.40 In-situ Soil Application Rate (gpd/ftz) Distribution Cell Information 100.00 Dispersal Cell Length Along Contour (ft) _ 1.00 Dispersal Cell Design Loading Rate (gpd/ftz) 1 Influent Wastewater Quality (1 or 2) ~~\ 2~ Pressure Disribution Information c Center or End Manifold 3.00 Lateral Spacing (ft) 4 Number of Laterals 0.125 Orifice Diameter (in) 2.50 ~ 'Orifice Spacing (ft) _ 2.00 Forcemain Diameter (in) 200.00 Forcemain Length (ft) 91.00 Pump Tank Elevation (ft) (~ X 6.50 System Head (ft) x 1.3 11.13 Vertical Lift (ft) 4.61 Friction Loss (ft) 0.00 In-line Filter Loss (ft) 22.24 Total Dynamic Head (ft) Lateral Diameter Selection in. dia. o tions choice 0.75 1.00 x 1.25 x x 1.50 x 2.00 x 3.00 x Note: Sand fill (D) calculations assume a Table 83-44-3 in-situ soil treatment for fecal coliform of <= 36 inches. 6.00 Cell Width (ft) Are the laterals the highest oint in the distribution Y network? F ~;~~:~: ~' cr N If N above, enter the elevation ft of the highest point. 7.50 ftz/orifice Does the forcemain drain back? Y 32.62 Forcemain Drainback (gal) 62.87 5x Void Volume (gal) 95.49 Minimum Dose Volume (gal) 32.95 System Demand (gpm) Manifold Diameter Selection in. dia. o tions c 1.25 x 1.50 x 2.00 3.00 r Gallonsllnch Calculator Treatment Tank Information 800.64 Total Tank Capacity (gal) 1200.00 Se tic Tank Capacity (gal) 36.00 Total Working Liquid Depth (in) Wieser Concrete Manufacturer 22.24 gal/in (enter result in cell B49) Dose Tank Information Effluent Filter Information 800.64 Dose Tank Capacity (gal) Pol Lok Filter Manufacturer 22.24 Dose Tank Volume (gal/in) PL-525 Filter Model Number Wieser Concrete Manufacturer Project: Sean Cawley 4-bedroom residential mound Page 2 of 9 Mound Plan and Cross Section Views . 1 /10 B • ~ . • •Observation •Pipe ' K. .. O :~ . . B.. .i. . .~. l~ . I_ I L Mound Component Dimensions s;~L . G S~ A 6.00 ft E ~:~i0 in H 1.00 ft K 1/.YZ 1~~:36 ft B 100.00 ft F 9.25 in z/ 3 12:91 ft L 122.53 ft.b`~' 22. G 0.50 ft J .~ 8-~0 ft W 26.'11 ft 600.00 (ft2) Dispersal Cell Area 1801.47 (ft2) Basal Area Available 6.00 (gpd/ft) Linear Loading Rate 10.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 104.35 (ft) ~I H Z F .:: ' : ~ ~~~~~~~ 103.08 (ft) Lateral Dispersal Cell 102.58 (ft)-~ - ."~ Invert Dispersal Cell :~ •p • ' • ~ ~ Elevation ;~~,:. ~; • ~ ~~ • a 100.75 (ft) Contour Elevation 5 5:B'% Site Slope Shading Key Topsoil Cap © ~{~~~ Subsoil Cap ©0 ASTM C33 Sand Tilled Layer []5 ~ Aggregate ~ o. . Q c 1.5 ft w o R ~ 0.5 ft 0 ~ ~ Dispersal Cell Q F Typical Lateral *- q ----* Geotextile Fabric Cover See lateral details on Page 4 for number, size, and spacing of laterals. Laterals are equally spaced from the distribution cell's centerline in the distribution cell (AxB). -, -+ _fi _l Project: Sean Cawley 4-bedroom residential mound Page 3 of 9 Center Connection Lateral Layout Diagram Force mai n connection Via tee ar cross to manifold at any point. •=Turn-up+~Vball valve ar I4. x~IFxr2; cleanautplug Holes drilled an the bottom of the lateral. ~~ Number of Laterals 4 Orifice Diameter Lateral Diameter 1.25 in Orifice Spacing (X) Lateral Length (P) 49.34 ft Orifices per Lateral Lateral Spacing (S) 3.00 ft Orifice Density Lateral Flow Rate 8.24 gpm Manifold Length System Flow Rate 32.95 gpm Manifold Diameter Total Dynamic Head 22.24 ft Forcemain Velocity Dose Tank Information Electrical as per NEC 300 and -- Comm 16.28 WAC Disconnect ~~ Laterals & Force main of PVC Sch 40 per COMkA Table 84.30-5 Laterals are identic al x.125 in 2.53 ft 7.50 ft` 3.00 ft 1.25 in Locking cover with warning label and locking device and sealed watertight ~4 in. min. ----~.__ Tank component is properly vented Wieser Concrete Ca aci 800.64 Volume 22.24 Manufacturer Gallons gal/inch -~ A B C D Dimension Inches Gallons A 18.21 404.91 B 2.00 44.48 C 4.29 95.49 D 11.50 255.76 Total 36.00 800.64 F- Alternate outlet location Forcemain diameter ~ 2 in. Weep hole or anti- siphon device Pum off elevation (ft) 91.96 Dom se tank elevation (ft) 91.00 Alarm Manuafacturer LevelArm Alarm Model Number DLV Pump Manufacturer Goulds -~ Pump Model Number EP05~ Pump Must Deliver 32.95 gpm at 22.24 ft TDM Project: Sean Cawley 4-bedroom residential mound Page 4 of 9 Mound Svstem Maintenance and Operation Specifications Service Provider's Name Bill Schumaker Phone 715 386-3121 POWTS Regulator's Name St. Croix Coun Zonin De 't. Phone 715 386-4680 Svstem Flow and Load Parameters Design Flow -Peak 600 gpd Maximum Influent Particle Size 1/8 in Estimated Flow -Average 400 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1200 gal Maximum TSS 150 mg/L Soil Absorption Component Size 600 ftz Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cful100 mL Service Frequency Septic and Pump Tank Effluent Filter Pump and Controls Alarm Pressure System Mound Other Ins ect and/or service once eve 3 ears Should ins ect and clean at least once eve 3 ears Test once eve 3 ears Should test month) Laterals should be flushed and ressure tested eve 1.5 ears Ins ect for ondin and see a e once eve 3 ears Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30-1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn-up Detail Finished •..,,.......•. ............... Grade 6-8" Diameter Lawn _-~ Sprinkler Valve Box / Distribution Lateral ~ f Threaded Cleanout Plug or Ball Valve Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Sean Cawley 4-bedroom residential mound Page 5 of 9 Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code General This system shall be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBD-10691-P (N.01/01), SSWMP Publication 9.6 (01/81), and Pressure Distribution Component Manual Ver. 2.0 SBD 10706-P (N. 01/01)] and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the finer is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October-February) dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BODS, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BODS, 30 mg/L TSS, 10 mg/L FOG, and 104 cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Contins~encv Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Pretreatment Units The information and schedule of mananagement and maintenance for pretreatment devices such as aerobic treatment units or disinfection units are attached as separate documents and are considered part of the overall management plan for this system. Project: Page 6 of 9 ~GOULDS PUMPS Submersible Effluent Pump 3871 EP05 APPLICATIONS Specifically designed for the following uses: • Effluent systems • Homes • Farms • Heavy duty sump • Water transfer • Dewatering SPECIFICATIONS • Solids handling capability: '/a" maximum. • Capacities: up to 60 GPM. • Total heads: up to 31 feet • Discharge size: 1'h" NPT. • Mechanical seal: carbon- rotary/ceramic-stationary, BUNA-N elastomers. • Temperature: 104°F (40°C) continuous 140°F (60°C) intermittent. • Fasteners: 300 series stainless steel. • Capable of running dry without damage to components. Motor: T,, • EP04 Single phase: 0.4 HP, 115 or 230 V, 60 Hz, 1550 RPM, built in overload with automatic reset. • EP05 Single phase: 0.5 HP, 115 V or 230V, 60 Hz, 1550 RPM, built in overload with automatic reset. • Power cord: 10 foot standard length, 16/3 SJTOW with three prong grounding plug. Optional 20 foot length, 16/3 SJTW with three prong grounding plug (standard on EP05). 2002 Goulds Pumps Effective September, 2002 83871 • Fully submerged in high grade turbine oil for lubrication and efficient heat transfer. Available for automatic and manual operation. Auto- maticmodels include Mechanical Float Switch assembled and preset at the factory. FEATURES ^ EP04 Impeller: Thermoplas- tic Semi-open design with pump out vanes for mechanical seal protection. METERS IFEET 1ot- V a z 0 ^ EP05 Impeller: Thermoplas- ticenclosed design for improved performance. ^ Casing and Base: Rugged thermoplastic design provides superior strength and corrosion resistance. ^ Motor Housing: Cast iron for efficient heat transfer, strength, and durability. ^ Motor Cover: Thermoplastic cover with integral handle and float switch attachment points. ^ Power Cable: Severe duty rated oil and water resistant. 9 30, s 25 7 ~i_ 6 s 4 3 z 0 20 15 _ _ \ EPOS -~ 10; ~~ EP04 5' _ ', , 00 _10 20 ___ 30 __40 50 GPM 3.? .954 •,o..rr..rr,'~l,:n tart' S ~r~[~ /`.e i~t rcv e% 0 2 4 6 8 10 12 m'/h caPaarv ^ Bearings: Upper and lower heavy duty ball bearing construction. AGENCY LISTING $P' Canadian Standards Association Goulds Pumps is ISO 9001 Registered. ~ --~f-S GPM ~ z.s ET j Goulds Pumps ~~/ ITT Industries ~ 7~9 ~. ~ , 08/11/08 MON 13:56 FAX 715 386 4686 ST CRX CO PLANNING SOIL EVALUATION REPORT t;~e--~--°f 3 %v sconstin Department of Commeroa )ivision of Safety and Buildings in accordance with Comm 85, Wis. Adm. Coda C~~y ~ 4 n list"'°. Attach complete site pia t I i12 11 in.~.~...... o _ 9. ~ ~ inGude, but not limited t . do fen percentsiopa, scale or dimensions, north a ,and U Please print a!! inforn Personal information you AroYida mey be used for yaeonde~ operty Ownlar 0e poi ; diirer~iortiaitid t Parcel I.D. ' lion and distance to nearest r~d. R Date ~ (P{ivbty Lew. S. 15,04 (1) (~~ l)• ~ZO~JIfVG 4F `~pertY cation B `~1 -~._. ~°-" 114 ~~ 114 S ~ T~8 N R 1 ~' Lot Stock # Subd. Name or t:SM# ~ ool property Owners Mailin dr ~ (~ ~ ~ n e pCi. dtpt.n~ S o~ ~ ~ ~ ~~5~4 u pal p Nearest Road ;try State Zip Code Phone Number ~~~,3 [ICY ~ ~t~t ~~ ~ ~ C ~~_ Code derived design flow rate Q ~ GPD ~ew Construction Use: [gl~esidential 1 Number of bedrooms ] Replacement ^ Public or commerciial -Describe: g,: D U e • l Flood Plain elevation if applicable parent material -J ,ran o~ ~~~ 3eneral comments I 1 G ~ ' a ~ `~ s~t'LC~ C~1^~ ~'~Y -N ~ ~~~G~ end V~'.`' {.~ity'i"~ 1~ ~] Baring in. Boring u Ground surface elev. g9~6 - ft• Depth -o limiting factor o1 ~'{ ic~itbn Rat L~l Pit ~tg GP Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary 'Eff#1 i .~ - - --•-- ~ n. sue. sh. --~--'-ti_ ^ Boring Boring ft u Pit Ground surface elev. ~r ft. i~ i Depth to limiting faCtOr ~ ~ In. recommend tons: Old ~AeL ~f u-1J' /'~~ ~ m~r. /` ,, '.~ 'l~0uul c~, Sy S -~e~ ~ Ieu, j9.9 Y G fLwr 1 G 0~/ll/08 MON 13:57 FAX 715 386 4686 ST CRX CO PLANNING ~6d~ ~~0.V1 ~, o~ g .~ ~s e ~r ~ ~C~w~ JUQ ~so~ ~c,~ ~ f ~.~Ke ~ckJ UcS~ec~ ~1 ~ .- ~.or s ~~ Pra Qa ~-- ~,o'f ". Corn e r M,ar ke r .~3 Nt- ~ cx~. no --~~ p a f t y `' pc~C ~~~e B.M. ~g~. ~: ~"{rv~ "~~"'7 t . .,~- y ~o ~ ~3t ~ 51~~ ~~ i - oti c~ ~ J D s ~~fid ~Y ~ ,~' qn d Q3~~, op~ ~ oa ~" _.- ~ 1~ qc{ #I~003 ~~f 9 ~9Gisconsifi-0epartmentoft~mmerce SOIL EVALUATION REPORT Page~of 3 Division of Safety and 8uifdings in accordance with Comm 85 Wis Adm. Code -'--'~- ~,- -,._ .._, County ,~.. Attach com late site la e/ t I s t i~t n i J h p n s~e ,Ptar+~~ust ~ 1/2 11 inl~ oln (BIC~j dire+ctbnand ft I fere~tce parcel LD p . o d t . ert o ot lim te -ans inGude, but percent slope, scale or dimensions, north ar ,and Ic;iCation and distance to nearest road. . /ys ~ /~ _ W' ~ /'V ' Please print all infor 'ation. ~;ijj. R Date Personal information you provide may be used for secondary purposes (Privacy Law s. 15.04 (t) (Ift)). ,, ~/ a ~ ( Property Owner I ~ ~~ ,i~~it_ ~~~~ ~,,__..., _~.~ ' iopertyLQcation ,_ / 'TOT `~~ 1/4 ~;~~ 1/4 S l T~8 N R ~ ~, E ( W Govt ~ ~ SC~G L . Property Owners Mailin~`ddres ~~ ~d ~ ` Lot ~ Block # Subd. Name or CSM# i v- e E~G~ c~0~ S Z ~ ~ ~ o -1.~ Qc5 CityL~, I ( WU~~I l1~ State Zip Code Phone N/umbper Ul?~ l)a~ c`7~S) C~`10 '~y`~3 ^ City ^~Village own Nearest Road ~.~c,~. ISC~L 1~ ~ ot~~ S l"~.e: [~lew Construction Use: (~esidentiat / Number of bedrooms ~_ Code derived design flow rate ®~ GPD ^ Replacement ^ Public or commercial -Describe: ~ Parent material -S i ~~ Flood Plain elevation if applicable D U C't~- '~. ~ I ' General comments d li / ` 5 r%' ~ ~ a i r 5~~~ ~`~~ ~~,r~ ~ ~ L p~ t~e~ I V'~' ~= F'~ ~~ cu~~ ons and recommen ~1~~ ~~~~ ~( • : L i'~~"' .~ {~l~~~ ~ /, Q 01't ~ v~ ~ ~` ! ~/~ ~~ ~~ . s s ~e ~ ~ I e ~, 99, 9 y ~~~w - ,. , _ y ~ `' ~ _~ L !. ' (J Boring ~ Boring # ~~ I~ Pit Ground surface elev. d~ , ~ ft. Depth to limiting factor a in• Soil ication Rate Horizon Depth in. - la Dominant Color Munsell (0 3' Redox Description Qu. Sz. Cont. Color `- Texture Sri! Structure Gr. Sz. Sh. k Consistence fr Boundary ~ Roots i v ~' P 'Eff#1 ~ D/f~ 'Eff#2 ~ $ (-^-i n (~nrinn 13onng s / ~ in. t_1 Pit Ground surface elev. r ft. Depth to limiting factor Soil A icaGon Rate Horizon ~ Depth in. b- 7- i Dominant Color Munsell ICS ~ o ~ SL 6 y ~ Redox Description Qu. Sz. Cont. Color ~ ~- o Texture c ~ S Structure Gr. Sz. Sh. ~ ~ ~ bk o s Consistence {'tn ~tr- r I v. Boundary i.~ (.~ Roots t F ~ ~ ~ - GP 'Eff#1 D/f~ `Eff#2 ,~ ' Effluent #1 = BC7U > 3V < ZzV mg/~ ano ~ ~~ Gov _ ia~ iiiyi~. •-•..~-.....- --- - -- ~ - - Signature CST N mbar CST Name (Pleatse Print) ~ ~ ~ ~ ~~ t'Ir`~t~2 -e~ eSdv~ Address i Date Evaluation Conducted Telephone Number s'v~~ ~ :~ ,~-' ,.: Property Owner ~C~~-l ~~~uC~- Parcel ID # Page ~_ of 3 a Boring # o jing Pit Ground surface elev. ,s ft. Depth ro limiting factor ~._ In. SoU lication Rate Horizon th De Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP p in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 `Eff#2 0 ~ 3 - ~n bK t ~ c,J ~ ~ (o 3 _ ~ (oy~ ~y _ .SCE ~ m `k •~ ~ ~~ , ~, ©~ 3P .s 2 ~ v~ S J c b u-~r - , ~~ Borinp # ^ Boring i-~ U Pit Ground surface elev. ft. ueptn to umiung raccor 'n• Soil lication Rate Horizon th De Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fg p in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 'Eff#2 i U Boring Boring # Ground surface elev. ft. Depth to limiting factor in. ^ Pit Soil lication Rate H i th D ant Color D i Redox Description Texture Structure Consistence Boundary Roots GP Dlft? or zon ep in. om n Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 `Eff#2 i I i- '. `Effluent #1 =GODS > 30 < 220 mg/L and TSS >30 < 150 mgll. `Effluent #2 =BODE _< 30 mglL and TSS < 30 mglL "I'he Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. till D-SJJO (R.07/00) Rio f P ~a~t ~, o~ g ~'~ ~ ~. M ea~u~s _f.~c~tter , ~Qlc~l wee ISO aa~a9~ 5 ~. 9 g `s`~e ~( .(Jr-~ e v e l.Uc~~ ~1 ~~- ~sy~ a QI ,~ y'" ,_ i o uti ~ ,_._, 5;,e,~~"dh1Y ~-- ,~ is 4 ~, l B3 1~ op~ ~- v a a _ -- ~. i ~r 8 ~a~e. 3 ° f 3 ProP~ ~~ Ro ~~- ~.ot' CDrr- e t- ~,~~ k~ Te p ~ f ~ ~'' PUC iP~~e `&M. 9~~ Tc ~ ~ 1 y ~~ Pu ~- P~,n e .~ ~©~- 9 ~~ ~~~ f ~ i - ~ 0 ~, l18 -~' ~ ~'~ ~ ~ ~ \ ~ 30 . /~ ,. ~ -~ ~ ~ r~ \ \~ , 9 / H WE = 1144.30 30 LBO = 1146 / / \~ C43' 3 ~ s .03 00 \ . / PG '( 9, J ~- - - p~P~~~`F'~ ~~ X21\ /\ / / ~ , ` \ N 89°28'53" W , / ~ 538.57' ~ ~ C ~ 4 ~ ~ I ~ - -~ B.M. TOP OF 3/4" IRON PIN 1 1 ~ ~ ~6 EL = 1147.63 ~ \ / ~~ _ \ w \ W ~ N \ ~O ~- ~ ~ rr I~ ~ ~ N N I~ M 0 p _ ~ '- W ~ = W W ~~ Z F- 'd- W N ~ ~ `~ N 89'57 '12" W Z o ; - Q - ow cv 614.19' z o N ~ 6' z 33' 33' , L2 LOT 8 ~ ~ w 160050 S.F. L23 ~ ~ rn N 5; 00 3.67 Ac. ~ Q r`~ "~ ° ' ' ~l - Y ~'~ a z h~o I ~~ g~ LOT J ~F, ~ ~ ~ :: 88278 S.F. r,,~; 2.03 Ac. ~~:~ a -1961.94'- 228.45' ,` 504.97' _ N 87'27'24" W 1994.96' ° ~, SOUTH LINE OF THE NORTH 1/2 OF THE NORTHEAST ~~~-~ UNPLATTED LANDS - d~~~e - - COUNTY PLAT DL>c.~#. 79ao7o LOCATION MAP WHITE PINE MEADOWS +, , iNOT IG SCAL[) LCCATEO IN Trir NCRiNEASi 1/a 0~ iNE NORiHE4311/4 qN0 IN 'HE ~~'S~ Sf. CROIXCO.W15 sECL~.OV , iiBN, R'6~4, IvCRiNNI=jT I/4 JF THE NOrt.NEA : 1/4 GF SECTION i i0Yrn5rNP 26 ^~OR14, wa~~e~a; 9 ~q ' r,nWE RANSt '6 We AY~iJ OF EM1~U CALLE, Si. CROIA COJN. JrISCCNSIN, d A nD I -AN„y~ voa~ 10 d VJ ' I ~ ~ ,z.Am, ~, --t ; ~ S 5~ dtIWY r, E~ ;0 t„ itt' s r c LRFLA1iEp LANDS PN i N - ~NORPi LINE CF THE V04THEgST 1/4 --_ ~ ~ - --------_- ~ -S8J'4146 E2657.10'- - ~~„Lw: ~SC„ `_ ... s 6r4r46` E 1312.67 -60~IN 1rENCE - - s r.._ .- - - - s.,i ~_ v 5°; ~D y ,,,7i' - .~ ----5cU~'--- -- - : 57<; ,6' C ~ ~ - -- - - S 8141'46" ~ _ _ I - .- - 50.16 „ ---- __ _ ~ c2 --- ~ i __._________._i4G h' c i -.t ______ E+ ___ , n 3'~IiO' _ -' __--__ Iff mE ~~t• ~~~ a.8 !'E75_eS^;. 31 1.15 1 MANN LEGEND , o ~ ; --------i ~ - ~ ~------~- o~ ~lo ~ 'I -- PAOPDSEC OR'YEWA't LOrA110AS , _. _ - _ ~- -- _ _ - - - - _ , _ ~ o ~, o _ -- -- lac' RpA~wAr <,E>TACH ~ 3 : n _.._ _ LOT 6 ~- ~ ~ ° i I ~. _ -_ w.AIR0.Cf A~ Id Eli ~:{RE " ~?°C~.b J.' ; 0 N ~ 8 r o _ l) 1 . ~ I I ' ' I 5:: A; Fl ~ - ~ 8.Ja3 '-. I JON- DPI4,ViAY EASEMENT -- - 50 1 Ni \ i r1 0 O Q IM / J '.. i I ~ "- I" ,1!111' ASEi1c.L' ~ m 0 ,,, ' ~ 4 ,~~, ; 9 3;'ei'GE 87t?51 I f0.9 ~ ses R.A. ~ Ib C" C S 8741'a6` E 330 00' -Z ~ a :~ i/;~ I IaOh =a, 1 °uue0 3/a ~ . r a r~- , \ ~ - > I ~ ~.o E4.S71 146.02 11316' ~ u ,~, COJN?Y SCr IOV "ORRER FOCND AS NOiE7 `~, "P\ ~ LOP ~ ~ ~ B.~. i 1 0 ~ ~ LOT ~ O'• \ ~ `5 Z ,263;6s~ ;:•I,a' N ~. ~- ~ S~ 11/^" BY IB iRJN PIN 4Y(. 4117 CBS./Fi, .9 \~. "~ ~ rW , II F 5.1~ ?; I' ~~ ~u a E. _ -0D ap ~ ~ BTbx S ° v m ~ I ~~~ _ ~ CAC 1c ' ~ .., . ,. ~ 4 m ~T ~ I 04 P:F T Q B 18 a _ Al ..\ ~ ~ C7 M ' ' 0 CUM1 Nr<I~i N an _ ~ I \. ~ ~° Es\ I . A ' 2 I •EC PCR EIREAF FOCI A~. All GSNER LCi C2P,NERS ~~\ ~ = IIK}7 HYF . ~ ~su.<J. [,,,;J ,:r, ~, \ A I I N F9`-1?" E ~ I ' . 11taJ0 I'~ / ° . I NYE = IIIP .'~ ' ~ Ser'S' I NwR-ILIAD .,:CN '.'A?ER E.VAi12P: ~ \ 1B0= . ~ \ , l90.11<2A7 ,-- . d \ 1 ;I ~ ~ - ' t~ ¢ - r ~ .. ,. m ti ~ - A - A m ~ L GT 3 ,, I ~ leG = IIISAD _OAfF 8040!6G OPENING 7, ry i ~ 6 - ~' .~ n c \ z~~ Irv ~ ~Pf~ 4~ ~LL S.E. ~" "N ~~b'. w o gW' 5i ~, C ~ ~ ~A. - "'p~ry~Z / \ z ~ ~I LOT ( 55d' i I C s 1~ ~~ s ro m 4 tt . -i ro ~ 9~~~>16 S.F. ~ ~ 9 La ~ s I. ~ I N o _ a~ n ~ufiSAC >," A IDP~r ~ -~, ye i ~~r,' o ~w~i z,o r aCURIN I rr r' \ Q~r. 15,~0'0.~ ~; a l 1. r 53 ~ "~ Ci A, iyW 9 ~ QEia .n m r di NOTES: Z ~ , ~ I - ~-, \ _< J~~~,. " P • ~ ;, ~ ac,NxDS uA e:tt,~n;,u lD me wmin un: a ms ? __ , ~, . < < ~ taj v S~ ~ ~ ~ ~ , Ng71AFA5, I/A D< LION I ON S7P T9 NLAII, AANGE In ~ I I \ 9/ !0 , ~ p 0 Z %L51 A NNEO .D 6C A d I,E f > i-<- ~ - - / ' I I N N J All ? PO'. GE D 6< L'NS!B'ARO N P901D4.1Y R PLH WART 1'ODW kfLL N E D7e W N' ' ' N I D' I -, I P'(,t ~ ~H P / ~ ~ Z F , . S SNWI 1Aa A WN6N N LE BDVE INE PIGH NACA I fb ' T ' ~ 0 ~~, ~~aA "~ _ -. . ~ N P AWN % t IESS fiPH t L QI . EfE, E:EVATON pN ~ ~ ° W N I N\ + I Q +` I SE16AC(5 EPoXi =':00' RIA ?5 SG"E= tS' 1COIABWIO~ ~ Z VE I . '~\ 1 O f '~ \\ % ! ~ I [ +; 1 I ~ e I I d S f A ~ I ~ UTILITY EASEMENTS: ~' ~ ~''~' `" ~ ~ i1414~ ° ~ ~ ° ~ . . ~~ ~ . I ~ ~ YN' 1175.E ( N `'r - ~i I I ~ ~ I ~ oD-nA1s I I ' i 110-°vE~ IPdOL@fS FX O ~PF(fO .JL~~IAI .11 Ji z NNE 1175$ ,:\ N yF ~ t ~ ~, ~ ~I NE 15rAlA1mN WuaO ±5 u 3 A Y SJAK iANF, CA L97 ,171 S6 ` I ~ I ~',lN V Cv ll:At ANY t01 A4 OP 5'AEii lM1f. LE f ,NABAA[E C A ,firr! SIAAE AY AN"ptt ~5 A MOa CIO CIIW117671 %SCO\SY AN1E5. ODLIIY I ` ;J LOP 8 r< I Y ~_ 'r 6A 4L 2i 1 U5 ~~ m rAS[N NS AS ', AEN Fi rAPi p fOA ~.,: JSE 8 sArmlmvAlB~ uIDSNAmcA P au P' i60iirJ SF. A`~.~1 ~'r JECr' ~ L , , : AREA ', CNI OSFAM r .2: rv A `AA LS . o n Qti ~ ~ ~L .~r fx~P~ ` ' nJ I ~ ' Z J~ \' [O1 9 ~ 9 A ~ FPM ~ DRAINAGE EASEMENT NOTE: q v k F s ~ i ~ - ITT 12 '~ ~ ~ s . , e ~ ~ ti 1 ° '` S ~ , e A ; i I , Nn aAnA ~ Pf40ENr SNm oo ANLMWD xam ~ruD [ 7 tr. D7 ; IIY E ( ._ I INII:'EA MP M ,ANGF "eE CP Aipl ;x ME F q„ . HA = I ~ ' ' WPAPfiD CONPiAEYNK NARF p NNALE MO 500. - -- - L I S n61tlES 9JI'S NCr EifS0.4 PL 5 FC4 715 PV 7i.19~ 1357 04 Z ' I ~ %~v ~ - N ° I I I , 0°.S RwMS A f 1%G FUV4, l~MRO 007A MC IPM i2e L6 , A ~~ ~~ ~ , fMgVAi G CA RA tiC I.'; Pln P !0 ASEVCA'S WAf;P 614 ~7 ' f~?'G I ~\ I '0 ovAwuc nmrt %ARA RxwArs, NARA easels, N 81'212?" W 1994 96' I Afi` ''~ %fn.'S C. fAAS~ F.N5S5~ . I t)9 ~ I ~SOU1H LINE OF THE NORTH 1~2 OF THE NOR I iHEAST 1~4 ~ uY,FLAiT_C LA[~IDS GENERAL NOTICE STATEMENT I` '~ j ~ . ~ n EAC'. P/PCF Jq%V r1S N P (V~,51 I W& C. 0 '"AR CWN ANC 1M1S'N UM AOtES AND ;/,ItII~'1~rEE-1 gyl ~ „' A:O.APh S (I E NE11N05, 4NNV Y I,O S E ALG 55 N ~ ABLE tI 1 &F„k' %1ACIUF160. lfl0 A8 AVY PAA[[ CF lWlO Vr „ iNE 51 fMN CWX'Y E"Nh 1 ~ aa~ ~+D wE ,APPALP:eIf 1oM aoAA7 rce ADau. ~ J : , c ~. ~ ~.D , MAERD er. AEIIN sAVUt ~ _ ~. , .L - I REA'iscG r/iZ/°s , • ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer S~-^~ Ca-w L C~ ,~-~., 1N.4-~1~ ~ e_ ~fJO ~ :s ~e ~iti, .~s'~d 9 Mailing Address / Q ! s-D y 8 Property Address '~ ~ ~ ~ k~ k x .$9 ~ ~v ~ ~/VO U 0 U ! L ~ ~ ~.Z' ~ (Verification required from Planning Department for new construction) City/State Ld7~ ~ Parcel Identification Number G ~~ ~ ~a a 9 •-a ~=~1oC> LEGAL DESCRIPTION Property Location ~ ~ '/., ~ '/a, Sec. ~ . T ~-~ N-R~W, Town of ~-~- ~'"4~'~-~ Subdivision la> ~-1 7~ ~i ~J ~- ~ ~l ~4-~ a ~ic~ S . .Lot # ~ ~ Certified Survey Map # ,Volume _, Page # Warranty. Deed # ,Volume .Page # Spec house ^ yes ~ no Lot lines identifiable ~j yes ^ no 4V~'i'FM TENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and/or (Z) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards sot forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin, Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. / ~/ SIGNATURE OF PLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. ~- ~ ~,~~ SIGNATURE OF PLICANT Zy~ o~ DATE «***** Any information that is mis-represented may result in the sanitary permit being revoked by the Zoning Department. ****** *• Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed State Bar of Wisconsin Form I-2003 WARRANTY DEED THIS DEED, made between Beneficial Investraenta, Inc. (°'Grantor", whether one or more), and Sesa Cawley, a sin;le person {"Grantee", whether one or more). Grantor, for a valuable consideration conveys to Grantee the fallowing described real estate, together with the rents, profits, faxturcs and other appurtenant interests, in St. Croix County, Stan; of Wisconsin ("Property"} (if more space is needed, please attach addendum): Lot 8, White Pine Meadow:, Town of Eau Gallq Si. Croix County, State of Wiscowin. inaui~i~rm~giwaiiaW~uiia~ 856869 KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX CO., Wr RECEIVED FOR RECORD 08/03/2007 09:20AM WARRANTY DEED EXEi1PI s REC FEE: 11.00 TRANS FEE: 98.70 paGES: I RETURN TO: Stan Cawley 101 SO City Wsllc Dr Woodbury, MN sS t 29 This is not homestead property. Togethtr with ail and singular the heseditaments and appurtenances thtreunto belonging; and Beneficial Investments, Inc.wartants that the title is good, indefeasible in fee simple and Sree and clear of encumbrances except: Easements, encumbrances and encroachments of record, and all exclusions or exceptions from coverage, if any, as set forth in the title irrsttraacc policy issued to Grantee as a part of this transaction, if such a policy was issued. Dated _ _. JltvDy ~I .2Q07 5elltr ~eneftcial Investments, Inc, by Paul Nelson Seller Signatures} AUTHENTICATION Authenticated on TITLE: MEMBER STATE BAR OF WISCONSIN (If not, _ __.__ autlwtized by Wis. Slat. § 706.Ob) THi51NSTRUMENT DRAFTED BY: Schrader Law Office. Tonal R Schrader s~zs2-r><~a ACKNOWLEDGMENT 'w~WIS "•~ STATE OF WISCONSIN ) f~~ •• •• ~+ ..~ St. Croix COUNTY ) y '' *`1L~Z~ yy * ERIC P. ; ~ Personally came before me on - ~ t HIV abave named Paul Nelson W the known to be n{s) who ,r V executefi.tite ~'efe~o_~igiastartnent and acknowl same.••:.v~/( Notary Public, Siste ofVViscansin My commission (is permanent) (expires: if '2Q'~3PO} (Sigashrts ruy bt autLutrcated or aelcnowtMged. Satt+ an rot aeoaaary.) NOTE: THi313 A STANDARD FORiN. ANY MODIFICAT10N5 TO TATS FORM SHOULD BE CLEARLY 1DS.W7'IFILD. WARRANTY DEED 2003 STATE BAR OF WISCONSIN FORM NO.1-2103 • Type name below signature. 1 of 1 File No.: 07-t)3ti92-AT'SH